Medigap

Medigap basics New laws have brought many changes to Medigap (Medicare supplemental insurance) policies. According to the federal government's Medicare site (medicare.gov), these changes give you choices in health care coverage to fill gaps in services that original Medicare doesn't cover. Basic benefits: Starting with policies effective on or after June 1, Hospice Part A co-insurance (outpatient prescription drug and inpatient respite care co-insurance) will be covered as a basic benefit.

These days, turning 65 doesn't have to mean hanging up your career, but it does represent one big milestone: Medicare eligibility. In most cases, signing up for Medicare Part A is a no-brainer. This coverage pays for in-patient care in the hospital. There's generally no premium, although you do pay a deductible and share other costs. You can sign up as early as three months before the month in which you turn 65 and as late as three months after your 65th-birthday month. To avoid...

A 91-year-old woman recently called AARP's local Medicare/Medicaid assistance program, upset that a collection agency was threatening to sue her over a $400 hospital balance. She couldn't understand why Medicare and her numerous insurance policies didn't cover the amount. Enter George Shell, 72, a local volunteer for the American Association of Retired Persons who tries to untangle health-insurance messes. But when he went over the policies, there was little he could do. The amount indeed was not covered.

Medigap basics New laws have brought many changes to Medigap (Medicare supplemental insurance) policies. According to the federal government's Medicare site (medicare.gov), these changes give you choices in health care coverage to fill gaps in services that original Medicare doesn't cover. Basic benefits: Starting with policies effective on or after June 1, Hospice Part A co-insurance (outpatient prescription drug and inpatient respite care co-insurance) will be covered as a basic benefit.

A consumer group says many older Americans may have to cancel insurance policies covering health-care costs that Medicare doesn't pay because their cost is climbing, commonly between 20 percent and 40 percent. With premiums on these supplemental policies, called Medigap, rising so fast, senior citizens will face difficult decisions on what they can afford, particularly if Congress decides to increase Medicare premiums next year, Families USA said Thursday. About three-quarters of senior...

What are the insurance choices for senior citizens who travel outside the United States three or four times a year for a month or so at a time? How do tourists in countries with socialized medicine pay for illnesses that occur and are treated there? The original Medicare plan, with a few exceptions, does not cover medical care outside the United States. The exceptions are if the condition occurs within the United States, and the most accessible hospital is across the border with...

Senior citizens saved themselves some tax money when Congress repealed catastrophic health insurance under Medicare. But starting Jan. 1, the bill for those "savings" will be coming due. You`ll see it in the price you pay for private Medigap insurance, which picks up many of the bills that Medicare doesn`t. In 1989, Medicare expanded to cover certain catastrophic costs at hospitals and skilled nursing homes. Consequently, that coverage was deleted from private policies.

The Clinton administration moved Friday to clarify the rights of older Medicare beneficiaries being dropped from health maintenance organizations, and it threatened to impose fines on insurance companies that refuse to sell them coverage. But under pressure from insurance companies, the administration backed away from an earlier interpretation of federal law that would have granted similar protections to people under age 65 who qualify for Medicare because of disabilities. ...

The Clinton administration moved Friday to clarify the rights of older Medicare beneficiaries being dropped from health maintenance organizations, and it threatened to impose fines on insurance companies that refuse to sell them coverage. But under pressure from insurance companies, the administration backed away from an earlier interpretation of federal law that would have granted similar protections to people under age 65 who qualify for Medicare because of disabilities. ...

Solid evidence exists that for some patients, health maintenance organizations (HMOs) can be hazardous to health. They don't take good care of the most vulnerable among the sick. In a recent study of the chronically ill, the elderly and the sickest poor fared much worse in three urban HMOs than their counterparts did in traditional health plans, reports John Ware, senior scientist at Boston's New England Medical Center. On the other hand, younger patients in his study--who had higher average incomes and...

When Dorothy Epstein of New York City retired four years ago, she bought a Medicare supplementary policy, called Medigap insurance, from Empire Blue Cross-Blue Shield. But she was unable to comparison-shop accurately, because the cost and features of her policy were similar but not equivalent to those of other policies. At the beginning of this year, though, Epstein found what she felt was a better deal and switched her Medigap coverage to a policy offered by the American...

A consumer group says many older Americans may have to cancel insurance policies covering health-care costs that Medicare doesn't pay because their cost is climbing, commonly between 20 percent and 40 percent. With premiums on these supplemental policies, called Medigap, rising so fast, senior citizens will face difficult decisions on what they can afford, particularly if Congress decides to increase Medicare premiums next year, Families USA said Thursday. About three-quarters of senior...

What are the economics of a Medigap policy when retiring to a foreign country? The purpose of a Medigap policy, private insurance that supplements Medicare, is to pay costs not covered by the federal Medicare program. Medicare generally does not cover health services outside the U.S., the primary exception being when a hospital in Canada or Mexico is more accessible than an American hospital. "Most Medigap plans provide some coverage for people who are out of the...

Soaring premiums are threatening to squeeze senior citizens out of the market for supplemental Medicare--or Medigap--insurance, according to a report released Thursday. But the insurance industry said the premiums are going up only as fast as Medicare claims costs, suggesting that the federal program is really to blame. In Illinois, premiums charged by one insurance company increased as much as 65 percent from 1995 to 1996, according to the report by Families USA, a...

By From an editorial by the Providence (R.I.) Journal | August 16, 1992

Medigap insurance is designed to provide health benefits for things not covered by Medicare, the government health insurance program for the elderly and disabled. . . . Up until recently, someone wanting to buy Medigap insurance faced a confusing jumble of policies, each offering different kinds of coverage. A welcome new federal law should help clear up some of the confusion surrounding Medigap insurance. It may also end the unsavory sales practice of enticing one individual to buy several policies-each...

Joan Beck's commentary on the Medicare bill headlined "Amazing tricks" (Op-Ed, Oct. 26) deserves a vigorous rebuttal. With regard to Medical Savings Accounts (MSAs), she has her facts completely wrong. MSAs were not developed by Golden Rule Insurance and then pushed by a think tank it helped to fund. It was the other way around. The particular think tank alluded to (National Center for Policy Analysis in Dallas) has been advocating MSA-type ideas since the late 1970s, along with many...

The Tribune is to be commended for its continued interest in costs of the delivery of health care. I was especially interested in an Oct. 22 article that examined health care costs if Congress repeals the Medicare Catastrophic Coverage Act. The article suggested that repealing the catastrophic law could send private insurance premiums higher than the act's $800 maximum surtax. Apparently, this conclusion was reached by adding $365 (the presumed increase in private medigap rates if the act...

When Harriet Davis turned 65, she decided she needed more coverage for medical bills than the federal Medicare program would pay. "I wanted to protect myself," she says. So Davis went to an insurance agent, figured out what she wanted and needed, then bought supplemental insurance, known as a Medigap policy. It has paid off. Twice Davis has been in the hospital with pneumonia. Both times, the policy, combined with Medicare, covered all her expenses. `I can sleep at...

Before Congress turns its attention to health-care reform, it should fix a glitch in a reform law that took effect two years ago. The new rules for Medigap insurance aren't always working as they should, depriving some older people of coverage they want. Under federal law, health-insurance companies can offer up to 10 standard Medigap policies, which cover expenses Medicare won't. They range from Policy A, which pays the basic deductibles, to Policy J, whose long...

Whether you're a first-time shopper or want to re-evaluate a current policy, here are some tips from experts to help you determine the best Medigap coverage for you. Initial factors you should consider are your medical history and what you can afford. If you've just turned 65, start looking now. At age 65, there's a six-month open enrollment period where you can't be turned down for a medical condition. "After that, seniors won't have as much choice," says Gail Shearer of...